Childhood Development after Cochlear Implantation

描述（由申请人提供）：人工耳蜗植入后的儿童发育（CDaCI）研究是一项多地点、前瞻性研究，研究对象是美国人工耳蜗植入儿童。我们的主要目的是评估植入后影响语言学习的变量的效果。人们认为，口语的成功源于其他发展领域的成功。因此，我们的目标是由假设驱动的，假设将植入后口语结果的变异性与环境、社会、干预和生物影响联系起来。幼儿研究的一个主要挑战涉及语言和其他交际行为的可靠抽样。我们通过分层测量和视频分析技术来应对这一挑战，这些技术使我们能够跟踪沟通技巧的出现。我们将以这项研究经验为基础，研究参与研究的儿童的口语技能是如何发展的，评估他们的：1。口语和读写能力；3、语音制作；4.语音识别；5.认知能力；6.社会互动与行为；与家庭成员的关系；与健康有关的生活质量。CDaCI研究的参与者包括5岁前接受人工耳蜗植入的儿童（n=188）和听力正常的对照组（n=97）。入组时平均年龄为2.2岁（Cl）和2.3岁（NH）。因此，当CDaCI的参与者从蹒跚学步的幼儿和学龄前儿童开始这项研究时，他们现在将开始他们早期的小学生活。尽管人们普遍认识到早期人工耳蜗植入的好处，但在临床、康复和教育策略方面仍存在不确定性，这些策略能否使人工耳蜗技术在口语习得方面发挥最大的潜力。语言结果修饰语变得更加引人注目，因为Cl儿童面临着他们小学早期的表现和社会需求。当我们收集更多的纵向数据时，我们将应用统计过程来全面评估跨领域的增长轨迹和绩效指标。一项前瞻性的、多维度的Cl与同时存在的NH对照组以及基于人群的对照组（NICHD）的研究，为研究儿童人工耳蜗植入后口语学习的变异来源提供了新的、可推广的见解。

DESCRIPTION (provided by applicant): The Childhood Development after Cochlear Implantation (CDaCI) Study is a multisite, prospective investigation of a large and diverse cohort of US children with cochlear implants. Our primary objective is to evaluate the effect of variables that influence language learning after implantation. Success in spoken language is seen to flow from success in other spheres of development. Thus our aims are driven by hypotheses that relate variability in post-implant spoken language outcome to environmental, social, interventional, and biological influences. A major challenge in early childhood research relates to the reliable sampling of language and other communicative behaviors. We address this challenge with hierarchical measures and videoanalytic techniques that allow us to track communicative skills as they emerge. We will build on this research experience to examine how spoken language skills unfold in children participating in the study, evaluating their: 1 .oral language and literacy skills, 2.speech production, 3.speech recognition, 4.cognitive skills, 5.social interaction & behavior, 6.relationships with family members, and 7.health-related quality of life. CDaCI Study participants consist of (Cl) children who received a cochlear implant before the age of 5 years (n=188) and a control group (n=97) of normal hearing (NH) age-mates. Average ages at enrollment were 2.2 years (Cl) and 2.3 years (NH). So, as CDaCI participants began the study as toddlers and preschoolers, they will now embark on their early elementary school experience. Despite wide recognition of the benefits of early cochlear implantation, there remains uncertainty with respect to clinical, rehabilitative, and educational strategies that enable cochlear implant technology to be used to its greatest potential for oral language acquisition. Modifiers of linguistic outcome become even more compelling as Cl children face the performance and social demands of their early elementary school years. As we gather additional longitudinal data, we will apply statistical processes to fully evaluate growth trajectories and indices of performance across domains. A prospective, multidimensional study of Cl with concurrent NH controls, as well as population-based control group (NICHD), offers prospects for novel, generalizable insights into the sources of variation in oral language learning after cochlear implantation in childhood.